新辅助化疗联合贝伐单抗治疗具有复发风险因素的可切除结直肠癌肝转移：一项多中心真实世界研究
Neoadjuvant chemotherapy combined with bevacizumab for resectable colorectal liver metastasis with risk factors for recurrence: a multicenter real-world study.
作者信息
Chen Yizhen, Zheng Yuanyuan, Wu Jia, Ye Rong, Jia Hangdong, Zhou Zhenyuan, Chen Weijie, Xu Linwei, Zhang Yuhua, Zheng Ming
机构信息
Fujian Key Laboratory of Geriatrics Diseases, Department of Geriatric Medicine, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, School of Medicine, Fuzhou University, Fuzhou, Fujian, China.
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
出版信息
Ther Adv Med Oncol. 2025 Mar 26;17:17588359251328457. doi: 10.1177/17588359251328457. eCollection 2025.
BACKGROUND
Currently, guidelines prohibit the addition of targeted drugs in neoadjuvant chemotherapy (NAC) for initially resectable colorectal liver metastasis (CRLM).
OBJECTIVE
Nevertheless, efficacy data of NAC combined with bevacizumab (Bev) for initially resectable CRLM with risk factors for recurrence (RFR) are lacking.
DESIGNS
We conducted a multicenter real-world cohort study to retrospectively analyze the efficacy and feasibility of NAC combined with Bev for CRLM with RFR.
METHODS
The patients were divided into the NAC alone group and NAC combined with the Bev group. We designated progression-free survival (PFS), objective response rate (ORR), and overall survival (OS) as the outcomes. Kaplan-Meier, Cox proportional hazards regression models, and subgroup analysis were utilized. RFR was a clinical risk score of 3-5. Subgroup analysis was applied to explore which subgroup was more suitable for NAC combined with Bev.
RESULTS
Between 2015 and 2020, this multicenter real-world study encompassed 335 CRLM patients from six medical centers who underwent curative hepatectomy following NAC. Two hundred seventeen patients were in the NAC alone group, and 118 received NAC combined with Bev. The NAC alone group exhibited an ORR of 51.15%, compared to 66.95% in the NAC combined with Bev ( = 0.005). The R0 resection rates achieved 91.71% for the NAC alone group and 94.92% for the NAC combined with Bev ( = 0.276). Three-year PFS rate was 27.6% for NAC alone and 41.5% for the NAC combined with the Bev group ( = 0.006). Furthermore, the 3-year OS was calculated to be 57.0% for the NAC alone and 66.7% for the NAC combined with Bev patients ( = 0.079).
CONCLUSION
For initially resectable CRLM patients with RFR, NAC combined with Bev exhibited a higher ORR and longer PFS.
CHINESE CLINICAL TRIAL REGISTRY
ChiCTR2400082966.
背景
目前，指南禁止在初始可切除的结直肠癌肝转移（CRLM）的新辅助化疗（NAC）中添加靶向药物。
目的
然而，NAC联合贝伐单抗（Bev）用于具有复发风险因素（RFR）的初始可切除CRLM的疗效数据尚缺乏。
设计
我们进行了一项多中心真实世界队列研究，以回顾性分析NAC联合Bev治疗具有RFR的CRLM的疗效和可行性。
方法
将患者分为单纯NAC组和NAC联合Bev组。我们将无进展生存期（PFS）、客观缓解率（ORR）和总生存期（OS）指定为观察指标。采用Kaplan-Meier法、Cox比例风险回归模型和亚组分析。RFR为临床风险评分为3-5分。应用亚组分析来探索哪个亚组更适合NAC联合Bev治疗。
结果
2015年至2020年期间，这项多中心真实世界研究纳入了来自六个医疗中心的335例CRLM患者，这些患者在接受NAC后接受了根治性肝切除术。单纯NAC组有217例患者，118例接受NAC联合Bev治疗。单纯NAC组的ORR为51.15%，而NAC联合Bev组为66.95%（P = 0.005）。单纯NAC组的R0切除率为91.71%，NAC联合Bev组为94.92%（P = 0.276）。单纯NAC组的3年PFS率为27.6%，NAC联合Bev组为41.5%（P = 0.006）。此外，单纯NAC组的3年OS计算为57.0%，NAC联合Bev组患者为66.7%（P = 0.079）。
结论
对于具有RFR的初始可切除CRLM患者，NAC联合Bev表现出更高的ORR和更长的PFS。
中国临床试验注册中心
ChiCTR2400082966。
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